Evaluation of the efficiency of preventive examinations of the adult population, aimed at early tuberculosis diagnosis

Abstract

BACKGROUND: In Russia, compared with other countries, at least 65% of the population must undergo an annual fluorographic examination for early tuberculosis detection.
 AIM: This study aimed to assess the impact of mass fluorographic examinations of the adult population on the main epidemiological factors and indicators of prompt tuberculosis detection.
 MATERIALS AND METHODS: The morbidity and mortality from tuberculosis have been analyzed along with the efficiency of its detection during preventive examinations, the proportion of destructive forms of the disease, and the 1-year mortality rate in four federal districts from 2014 to 2019.
 RESULTS: For all districts, low efficiency of preventive examinations was registered (1 patient per 2,0005,000 people examined), as well as its strong correlation with morbidity and, in case of its absence, with the coverage of examinations. The change in morbidity and mortality rates over time was independent of the mass screening volume of the adult population. The relative risk indicators of increased morbidity and mortality with a decreased number of examinations were 0.4 and 0.3, respectively. The increased coverage of the population with examinations was not accompanied by an improved indicator of detection timeliness, namely a decreased incidence of destructive forms and 1-year mortality rate. The incidence of tuberculosis is determined by socioeconomic factors, which influence the level and living conditions of the population.
 CONCLUSIONS: This study established the low efficiency of mass fluorographic examinations of the population, lack of influence of coverage with examinations on the epidemiological situation, and the timeliness of tuberculosis detection.